Orthopaedic Seat Cushion for Patients for Pressure Relief

Pressure ulcers are skin breakdowns caused primarily by excessive applied pressure. Heat, moisture, friction, poor nutrition, vascular problems, and inability of a person to move are also contributing factors to this, among many others. Presence of these ulcers already has a significant negative impact on an individual and failure to provide protection to the skin for these not to occur, imposes more complications and risks. Prevention of pressure ulcers is a vital measure, and this include proper hygiene, pressure relief, proper skin inspection, and provision of appropriate seating surfaces.

For seating surfaces or seat cushions, they are chosen based on the medium and properties of the materials used in their construction: foam, air, gel, or combination types. They vary in efficacy based on pressure distribution, provision of stability, ability to insulate, or conduct heat, and the reliability of their performance over time (Frontera & DeLisa, 2010). Seat cushions are preferably prescribed and designed specific to the medical and functional needs of an individual and should promote improved positioning, pressure relief, and comfort.

 

Questions to Consider in Choosing Seat Cushions

  • Does the seat provide adequate support to promote good sitting posture?
  • Will the pressure distribution of the seat prevent pressure sores?
  • Is the shape of the seat cushion appropriate for the user’s body contours?
  • Does the person need a custom-shape to accommodate deformities and maximize support?
  • Are special combinations of foam, air, or gel seat cushions needed to maximize comfort and pressure relief? 

Note: Adapted from Physical Rehabilitation 6th Ed. by S.B. O’ Sullivan, T.J. Shmidtz, G.D. Fulk, 2014, p.1418, FA Davis Company

 

Seat Cushions

Cushion Type

Image

Application

Benefits

Limitations

Plain Rectangular foam

Low-risk patients

Inexpensive

No pressure relief regions; wears out easily; low maintenance

*Contour-molded with gel-filled inserts

Higher risk patients prone to ulcers

Molds to body contours

Heavier than regular foam cushions; uncomfortable when cold

*Matrix or air-filled elastic capsules

High-risk patients who cannot maintain skin integrity with foam products

Improved pressure relief; bladders can be tied off to create pressure relief regions

More expensive than foam cushion; bladders can be punctured; high maintenance

Carve and assemble foam

For patients with asymmetries needing custom cutouts

Lightweight, Low-cost

Custom-fitted; hard to replicate

Alternating air cell inflation

Very high-risk patients with intractable ulcers

Battery-powered air compressor sequentially inflates and deflates cells

Expensive; more complex;  requires charging

Note: Adapted from Braddom’s Physical Medicine and Rehabilitation 5th Ed. by D.X. Cifu, 2016, p.334, Elsevier

*Product Images from Healing From Home


READ SUGGESTED ARTICLE: CHOOSING A SUITABLE MOBILITY DEVICE (PART 1) - WALKERS, CRUTCHES AND CANES



References

Frontera, W. R., & Delisa, J. A. (2010). DeLisa’s Physical Medicine & Rehabilitation: principles and practice. Lippincott Williams & Wilkins Health.

‌Md, D. C. X. (2015). Braddom’s Physical Medicine and Rehabilitation (5th ed.). Elsevier.

O’Sullivan, S. B., Shmidtz, T.J., Fulk G.D., (2014). Physical Rehabilitation 6th Ed. FA Davis Company.

 

Image sources

Alternating air cell inflation [Photograph]. (2015). In Braddom’s Physical Medicine and Rehabilitation (5th ed.) (p. 334).

Carve and assemble foam [Photograph]. (2015). In Braddom’s Physical Medicine and Rehabilitation (5th ed.) (p. 334).

 Contour-molded with gel-filled inserts. (n.d.). Retrieved from https://www.healingfromhome.com/collections/seat-cushion

 Matrix or air-filled elastic capsules. (n.d.). Retrieved from https://www.healingfromhome.com/collections/seat-cushion

 Plain Rectangular foam [Photograph]. (2015). In Braddom’s Physical Medicine and Rehabilitation (5th ed.) (p. 334).